QEEG-Based Protocol Selection: A Study of Level of Agreement on Sites, Sequences, and Rationales Among a Group of Experienced QEEG-Based Neurofeedback Practitioners


  • Mark L. Johnson
  • Genie Bodenhamer-Davis




Background. The history of neurofeedback is marked by a diversity of theoretical bases and specific protocol development approaches, including standard protocols based on research, symptom/neurophysiological function-based approaches, and approaches based on quantitative electroencephalography (QEEG) assessment (Budzynski, 1999; Demos, 2005). Although this diversity of approaches currently characterizes clinical practice within the field, one might assume that a certain degree of uniformity exists among practitioners who follow one particular treatment model. That is, clinicians who follow a symptom/function-based approach might be expected to select similar protocols for a given client, and practitioners who base their protocols largely on QEEG likewise would develop similar protocols for the same client. Method. To test this latter assumption, 13 neurofeedback practitioners having 5 to 20 years of experience using QEEG and neurofeedback were sent the same QEEG data and presenting problems of a female adult who had previously sought neurofeedback treatment. The participant’s data were edited in both NeuroReport and NeuroGuide, and both edits were provided to the survey participants. The practitioners were asked to provide treatment protocols covering sites, frequencies, sequences, and so on, as well as rationales that supported their protocol selections. Results. Ten of the 13 professionals contacted responded to the survey. Respondents were in general agreement as to which sites and frequencies to treat. However, they diverged in their sequencing of treatment sites; in whether to inhibit, reinforce, or both; in cautioning about reference contamination in the QEEG record; and in their theoretical rationales for their protocol selections. Conclusions. Although further research will have to document the efficacy of the various protocols recommended by the experienced QEEG-based practitioners surveyed for this study, it can be assumed that these practitioners are finding some consistent success using them in their practices. Therefore, the primary implication of this study appears to be that as long as appropriate treatment sites and frequencies are addressed for a given client, competently applied neurofeedback seems to be robust enough to tolerate a relatively wide diversity in specific protocol configurations.